(CN) – Developed nations can contain health care costs while maintaining a healthy population by spending more of their health care budgets on social services, according to a new study.
The report, published Monday in the Canadian Medical Association Journal, analyzes more than 30 years of data from nine of Canada’s 10 provinces to determine whether social and health financing ratios were associated with overall population health.
The findings suggest that addressing the social determinants of health – living environments, income and education – by boosting spending on social services can help treat the underlying causes of poor health and disease.
Despite the potential wellness benefits of social services, however, health care continues to receive the majority of spending.
“Spending more on health care sounds like it should improve health, but our study suggests that is not the case and social spending could be used to improve the health of everyone,” said first author Daniel Dutton, a postdoctoral scholar at the University of Calgary in Canada.
“Relative to health care, we spend little on social services per person, so redistributing money to social services from health care is actually a small change in health care spending.”
In the reviewed data, average per-person spending on social services was $930, compared with $2,900 for health services. Per-person health spending grew ten-fold over social spending during the study period. However, more social spending per dollar spent on health care is linked to improved health outcomes across the provinces.
“Social spending as a share of health spending is associated with improvements in potentially avoidable mortality and life expectancy,” Dutton said.
“If governments spent one cent more on social services per dollar spent on health by rearranging money between the two portfolios, life expectancy could have experienced an additional 5 percent increase and potentially avoidable mortality could have experienced an additional 3 percent decrease in one year.”
The findings should impact how governments allocate funds. Governments have boosted health spending as their elderly populations grow, leading to the spending disparity.
“If social spending addresses the social determinants of health, then it is a form of preventive health spending and changes the risk distribution for the entire population rather than treating those with disease,” said Dutton.
“Redirecting resources from health to social services, that is, rearranging payment without additional spending, is an efficient way to improve health outcomes.”
Writing in a related commentary, Paul Kershaw of the University of British Columbia says the team determined that increased health spending “is associated with lost opportunities to improve life expectancy and prevent avoidable mortality by comparison with a more even distribution between medical and social investments.
“These results add to evidence that should impel governments to seek better balance between medical and social expenditures.”
Prince Edward Island and Canada’s territories were not considered due to insufficient data.